4Bb. Anxiolytics And Hypnotics

Front 1

What is an axiolytic?

Back 1

AKA Sedative, makes you calm

Front 2

What is a hypnotic?

Back 2

Produces drowsiness

Front 3

Drugs that Cause sedation as a side effect?

Back 3

Antihistamines and neuroleptics

Front 4

What is a Sedative Hypnotic?

Back 4

1. Anxiety reducers that cause Sleep at high doses

Front 5

What is anxiety?

Back 5

1.Adaptive response to a threatening event
2. Hyper vigilance

Front 6

What is chronic anxiety?What kind of problems come with it?

Back 6

1. Maladaptive response
2. GI, CV and neuro problems

Front 7

What is the neurological structure of anxiety?

Back 7

1. Amygdala

Front 8

What period do the anxiolytics work on?

Back 8

During the anticipatory peroid

Front 9

What is acute anxiety caused by?

Back 9

Specific Events

Front 10

What is panic disorder?

Back 10

Acute sever anxiety with the sense of impending doom

Front 11

What is GAD? What do you treat it with?

Back 11

1.Persistant state of fear and apprehension about the future.
2. Buspirone

Front 12

What do the Benzo's end in except 1?

Back 12

PAM or LAM except chloridzepoxide

Front 13

What do the Barbituates end in?

Back 13

TAL

Front 14

What are the antihistamines?

Back 14

1. DPH or OH
2. -INE

Front 15

What are the non-sedating anxiolytics?

Back 15

1. Buspirone
2. Propranolol

Front 16

What is Buspirone?

Back 16

1. Treat GAD
2. A Serotonin-R agonist

Front 17

What are the 3 Z's and what do they do?

Back 17

1. Zolipedem, Zalaplom, and esZopiclone
2. Bind GABA-a
3. Used for sleep

Front 18

What drugs are used the most as sedative-hypnotics?

Back 18

1. The BZDs, safer than Barbs
2. Carbamates and alcohol are others

Front 19

What are the five levels of CNS effects?

Back 19

1.Sedation/Anxiolysis/Disinhibition
2. Hypnosis
3.Anesthesia
4. Medullary depression
5. Coma

Front 20

How far do Benzos go vs. Barbs in CNS dose dependent effects?

Back 20

Benzos get to anesthesia and and little medullary depression.

Barbs can go all the way to coma and death

Front 21

What is the number 1 script for panic disorder?

Back 21

Alprazolam

Front 22

What are the common benzo's used for anesthesia?

Back 22

1. Diazepam
2. Midazolam

Front 23

What is the goal for dosing and how is it accomplished?

Back 23

To take less dosage usually by increasing the half life. Tis is for better complaince

Front 24

Name some short, intermediate and long lasting benzo's and their 1/2 life?

Back 24

1. Midazolam(colonoscopy) - 2-6hours
2. Alprazolam(panic disorder) - 12-15hrs
3. Diazepam (Seizure) - 20-80hrs

Front 25

Where are basic drugs absorbed? What does this say about time of action?

Back 25

1. BZD absorbed in Duodenum
2. Late onset

Front 26

What are the acid anxiolytics and where are they absorbed? What time of action?

Back 26

1. Barbs in the stomach
2. Rapid onset

Front 27

When given benzo's or barbs in an IV which one has a slower dose response curve?

Back 27

Neither they have the same

Front 28

What is the receptor target for Benzo's?

Back 28

GABA-a-R

Front 29

What is the MOA of Benzo's?

Back 29

1. Gets GABA to GABA-a
2. The CL- channels open more

Front 30

What is Diazepam used for?

Back 30

Anxiolytic and anticonvulsant.

Front 31

What is the electrophysiological response to valium?

Back 31

Increased IPSP

Front 32

What does an antagonist do to the electric potential?

Back 32

It will do nothing, can be used as an antidote

Front 33

What will an inverse agonist of GABA-a do?

Back 33

Make you anxious

Front 34

GABA-R alpha 1 has what effect? Where is it localized?
What Drugs?

Back 34

1. Affects sedation
2. Cerebellum, and cortex
3. Ambien and the 3 Z's

Front 35

What does the GABA-a-R subunit alpha 2 and 3 do? Where is it localized?

Back 35

1. 2 is Anxiolysis and 3 is anxiogenic
2. Amygdala

Front 36

What does GABA-a-R subtype alpha 5 do? Where is it located?

Back 36

1. Decrease cognition with BZD
2. BZD will get you stupid
3. Hippocampal region

Front 37

What is the antidote to BZD?

Back 37

1. Flumazenile

Front 38

What doe Zolpidem and Zaleplon do?

Back 38

1. Short acting
2. easy sleep with little side effects

Front 39

What does esZoplicone do?

Back 39

1. Long acting
2. For chronic insomnia

Front 40

What are the MOA of Barbs?(3)

Back 40

1.Bind GABA-a-R, and depress the RF
2. Glycine and GABA have more effect
3. Inhibit AMPA glutamate-R = DEATH

Front 41

What is the buspirone MOA?

Back 41

1.12 degree agonist of serotonin 1A

Front 42

Where do the 3 Z's hypnotic drugs bind?

Back 42

Same place as the BZD

Front 44

What is sedation?

Back 44

Decreased level of responsiveness to constant stimulation

Front 45

What is hypnosis? And the problem with these drugs?

Back 45

1. Sleep
2. REM is usually decreased
3. Withdrawal may cause REM rebound

Front 46

What do the effects of sedative-hypnotics depend on?

Back 46

Depend on the lipid solubility(barbs is high)

Front 47

What are the most lupid soluble sedative hypnotics?

Back 47

Barbs such as Thiopental and methohexital

They quickly penetrate the brain tissue

Front 48

What sedative hypnotics are generally used as anesthetic agents?

Back 48

Midazolam and Diazepam, usually in adjunct.

Diazepam cannot work alone

Front 49

What are the 3 anticonvulsant BZD and Barbs?

Back 49

1. Phenobarbital, Diazepam, Lorazepam
2. Must administer intravenously

Front 50

What sedative hypnotics would you use for muscle relaxation?

Back 50

Most are not used because of high CNS depression, use Diazepam for specific spasiticity like cerebral palsy

Front 51

What is the dangers of sedative hypnotics?

Back 51

At high doses can cause medullary depression and death

At therapeutic doses can affect patients with COPD to supress respiration even more

Front 52

What is tolerance?

Back 52

A decrease in responsiveness to the drug to where increased levels needed to achieve same response

Front 53

What is physical dependence?

Back 53

Synapse remodelling

Can cause the body to actually need the drug to prevent the symptoms it was used to treat

More common in shorter acting and unlikely in Buspirone

Front 54

What sedative hypnotics would be used for Anxiety?

Back 54

BZDs becuase low levels do not impair motor

Front 55

#1 drug for panic disorder and agoraphobia

Back 55

Alprazolam

Front 56

What are the adverse effects of sedative hypnotics?(3) Other contra indication?

Back 56

1. Excess CNS depression
2. Decreased pyschomotor
3. Drowsiness/dizziness

4. Usually occur in ones with long half lives like Flurazepam
5. Make sure the elderly do not get overdosed

Front 57

What is additive CNS depression?

Back 57

1. Sedative hypnotics with CNS depressants are additive
2. Ethanol most common
3. Buspirone lease additive

Front 58

What is Cimetidine?

Back 58

1. Decreases metabolism of drugs, will increase the effects
2. H2 antagonist for Heartburn

Front 59

What is Flumanizile?

Back 59

Benzo Antagonist, not for barbs